Friday, November 6, 2009

Pedohebephilia. Hypersexuality. Coercive Paraphilic Disorder. How many new sexual disorders can fit into the DSM-V, the American Psychiatric Association diagnostic manual scheduled for publication in 2012?

Government evaluators in Sexually Violent Predator cases must be thrilled with the possibilities being generated by the prolific paraphilias subworkgroup of the DSM-VSexual Disorders Workgroup. If these proposed diagnoses make it into the psychiatric bible, the task of establishing that sex offenders have bona fide mental disorders meriting hospitalization will suddenly get a whole lot easier.

But this will only happen if good science is not allowed to interfere with pragmatism and pretextuality. After all, the empirical support for some of these pseudoscientific categories is weak at best.

Now issuing a strong call of alarm is perhaps the premiere scientific researcher into the etiology of rape, Raymond Knight, the Mortimer Gryzmish Professor of Human Relations at Brandeis University.

Currently, the propensity to rape is not considered a mental illness. Proponents of adding a rapist diagnosis to the Diagnostic and Statistical Manual of Mental Disorders (DSM) claim it was only excluded the last time around due to pesky feminists' objections that it would excuse rapists from criminal consequences. However, that turns out to be something of a myth. The main reason it was excluded, says psychologist and lawyer Thomas Zander, who conducted primary research into the history, was because it was not scientifically supportable. And, according to Knight's article, it is even less supportable now than it was back then.

The fact that rape propensity is not a bona fide mental illness has proved a hurdle for the civil commitment industry. To be hospitalized on the basis of possible future dangerousness, sex offenders must be found to suffer from a mental disorder that reduces their volitional control. To get around this legal barrier against unconstitutional preventive detention, government evaluators have taken to assigning a de facto label of "Paraphilia Not Otherwise Specified - Nonconsent."

As Knight points out, if Coercive Paraphilic Disorder is introduced into the DSM-V, it will provide tacit support for the legitimacy of the bogus "NOS" diagnosis. This, he says, would be a travesty:

"The inclusion of PCD [Paraphilic Coercive Disorder] would inappropriately legitimize this 'disorder' and grant it the imprimatur of the DSM, which is almost universally cited by expert witnesses in civil commitment proceedings…. The diagnosis has little empirical support, and it would be a travesty to grant it a status that would perpetuate its misuse."

In his article, Knight discusses the evidence from a long line of research that suggests there is not a separate category of men with a propensity to rape. Rather than being a distinct "taxon," rape propensity exists along a continuum.

He also challenges the contention of a Canadian research group that rapists are sexually aroused by the coercive aspects of sexual assault. A more likely scientific explanation for why some men rape is that the coercive elements of the situation fail to inhibit their sexual arousal, he writes.

This dimensional model coincides with a large body of sociological and anthropological research, which suggests that men in certain environments -- most notably wars -- are much more likely to commit rape. Indeed, research has found that even on the same college campus, some fraternity environments promote a "rape culture" among men, whereas others do not. (I discuss this environmental aspect of rape in an article I wrote a few years back on the theatrical elements of group rape.)

Knight's scientifically grounded critique is a refreshing change from the pseudoscientific tenor of many of the DSM diagnostic proposals. More scientific rebuttals to some of the shaky studies in the sex offender field are currently in press, and I will try to stay attuned and alert you readers as soon as they become publicly available.

Further resources:

Knight, Raymond. (2009). Is a diagnostic category for Paraphilic Coercive Disorder defensible? Archives of Sexual Behavior. This article is online, but requires a subscription. The abstract is visible HERE, along with the email address of the author (from whom copies may be requested).

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Karen Franklin, Ph.D. is a forensic psychologist and adjunct professor at Alliant University in Northern California. She is a former criminal investigator and legal affairs reporter. This blog features news and commentary pertaining to forensic psychology, criminology, and psychology-law. If you find it useful, you may subscribe to the newsletter (above). See Dr. Franklin's website for more information.

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